Background Circulating autoantibodies are one of the main characteristic of autoimmune disease as systemic lupus erythematosus (SLE). The associations between anti-DNA antibodies and renal disease, anti-Ro with cutaneous manifestations and congenital heart block are well established. The human ribosomal P proteins (RPP) designated PO (38 kd), P1 (19 kd), and P2 (17 kd), the clinical significance of these antibodies is disputed, but some data suggest an association with aggressive disease, nephritis, central nervous system (CNS) abnormalities.
Objectives The aim of the present study was to determine the possible clinical and immunological associations of anti-RPP antobodies in SLE.
Methods Serum samples from 68 patients with SLE who satisfied the American Rheumatism Association revised criteria for SLE entered the study. Anti-RPP activity was determined by ELISA (TRINITY BIOTECH RIBOSOMAL P 1gG, A, M), the specifity was confirmed by Western blotting (Wb). Antinuclear factor (ANF) was detected by indirect immunofluorescence, anti-DNA -by ELISA, anti-Ro, La, RNP, Sm antibodies -by double immunodiffusion, CRP, C3, C4-by radial immunodiffusion.
Results Anti-RPP antibodies were demonstrated by ELISA in sera of 13 patients (19%). 17 sera were investigated by Wb, 6 of them were positive by both ELISA and Wb, another 11 were negative as in ELISA, as in Wb. Anti-P reactivity was against 38 kd (P0), 19 kd (P1) and 17 kd (P2) in one sera; 38 kd and 17 kd (PO, P 2) in 4 sera; and 38 kd (PO) also in one sera. SLEDAI score was 13,6+ 8,65 in seropositive group, and 16,7+25,82 in seronegative. The frequency of nephritis, CNS involvement was significantly higher in RPP-positive patients-38,5% (5/13) and 38,5% (5/13) against 7,3% (4/55) and 18%(10/55). In the group of 15 SLE patients with CNS involvement 5 (33%) had increased anti-RPP antibody levels. The highest levels of anti-RPP had 3 patients with agressive disease, all of them had nephritis, one also psychosis-convulsions, and one-hemolytic anaemia.
Conclusion In conclusion, we suggest that anti-RPP antibodies may be a good serological marker for not only SLE, but for aggressive duration of disease, including damaging of kidney and brain.
(abstract for oral presentation).
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